Health Articles

Knowledge

Myofascial pain syndrome (Office Syndrome)

Dr.Paraminth Chaivibulphol

Nowadays myofascial pain syndrome has become very common, due to repetitive work in front of computers. We hardly walk, stand, or even move. Moreover, while we use our mobile phones to text or otherwise, our heads tilt forward and shoulders curve. Consequently, we develop back and neck pain. This phenomenon is known as “Text Neck”. Text neck can lead to myofascial pain syndrome in the head, neck and shoulder region.

Myofascial pain syndrome can be temporary relieved by massage. However, if the posture is not corrected, it will become chronic and dangerous to your musculoskeletal system. Moreover, myofascial pain is strongly related to migraine. If you suffer from severe migraine, myofascial pain syndrome treatment together with migraine prevention medicine is the best remedy.

What is myofascial pain syndrome?

Myofascial pain syndrome is a chronic pain disorder, whereby pressure on sensitive points in your muscles (trigger points) causes pain in the muscle and sometimes in seemingly unrelated parts of your body. This is called referred pain.

>Back to contents

What causes myofascial pain syndrome?

Myofascial pain syndrome is caused by repetitive muscle work. This can be due to repetitive motions used in jobs or hobbies, or by stress-related muscle tension. For example, sitting in front of the computer or tilting your head forward to text with the mobile phone, are repetitive works commonly seen nowadays.

Once the muscle becomes injured by repetitive contractions, trigger points develop. Trigger points are palpable nodules within the tight muscle; it can be at the center of muscle belly or at the end plates.

Trigger points creates muscle tenderness and referred pain. For example trigger points in the upper trapezius muscle, a muscle in shoulder regions, could trigger pain in neck and head. This is one of the most common muscles involved in myofascial pain syndrome in office workers who spend all day sitting in front of computer, leaning forwards with curved shoulders.

Trigger point treatment which can resolve myofascial pain include trigger point injection, muscle stretching, posture correction and aerobic exercises.

>Back to contents

What are myofascial pain symptoms?

Muscle tenderness and referred pain. The pain can range from a dull ache to a shooting, sharp pain. It can occur in any area of the body but is most commonly around the head, shoulder and back region. If not treated properly, the pain can become chronic.

Apart from pain, some patients report dizziness especially when turning their head from side to side. This is an autonomic phenomenon that occurs with trigger points in sternocleidomastoid muscle. This specific muscle functions as a neck flexor, and is therefore one of the common muscles involved in office workers.

Another common autonomic phenomenon is sensory disturbance. Some patients report numbness, goose bumps or hyperesthesia in their arms or neck. These symptoms may cause patients to be anxious and fearful, due to the similarity to other life threatening disease such as stroke. Neurologist consultation is often involved.

Sometimes myofascial pain syndrome can be secondary to abnormal anatomy of the body, for example spinal scoliosis, herniated discs, or spine degeneration. Some of these diseases should not be left untreated and doctor consultation is mandatory.

>Back to contents

Who is at risk of myofascial pain syndrome?

Myofascial pain syndrome can occur to anyone. However, those with higher risk of the syndrome are people who perform repetitive works, such as office workers. Similarly, sport injuries from inappropriate posture can also result in myofascial pain syndrome.

Below is a list of some of those at risk of myofascial pain syndrome:

Hunching over a smartphone or computer for more than 6 hours a day
Professional chefs or bakers performing repetitive actions of standing and cooking
Drivers, especially after long hours driving

4. Athletes

5. Women wearing high-heel shoes for extended periods of time are at risk of myofascial pain syndrome in the

thighs and back

>Back to contents

Myofascial pain treatment

Acute treatment

Trigger point injection and dry needling can relieve the pain effectively and immediately. Trigger point injections are performed by inserting a small needle into the patient’s trigger point. The injection contains a local anesthetic or saline, and may include a corticosteroid. Following the injection, the trigger point is made inactive and the pain is alleviated. Several sites may be injected in one visit. The dry-needle technique whereby no medicine used is also an effective alternative.

Massage and physical therapy is another effective remedy for myofascial pain. Physical therapy is less invasive but more visits are required, compared to trigger point injections. Physical therapy includes electrotherapy, ultrasound diathermy therapy, laser therapy, shock wave therapy and peripheral magnetic stimulation. Choosing the best modality for each patient depends on the expertise and experience of the doctors.

Acute treatment, though effective, provide temporary pain relief. For a more sustainable approach, poor posture should be corrected and exercise therapy should be considered.

Key points to a proper ergonomic workstation include:

The monitor height should be placed so that the eyes are in a horizontal plane.
The keyboard and mouse should be positioned such that the elbow is in 90 degree flexion.
The wrists should be in a slightly extended position.
The hips should be at a 90-degree angle and the feet placed flat on the floor.
The head, shoulder, and hips should be aligned, with the back supported by the chair.

Office workers are advised to relieve muscle tension every 30 minutes, without interrupting the train of thought by setting an interval-timer and placing it across the room. Then they must get up and can stretch while they walk to turn off the buzzer and reset the timer.

Exercise therapy

Exercise is the most important therapy. Multiple modalities of exercise should be considered, including:

Stretching exercises: Stretching is one of the most important steps. Any method that can gently stretch and lengthen a muscle can be considered, including self-stretching using the Anderson technique, or therapist-assisted methods such as Travell and Simons technique, or Janda technique. Yoga is also considered an alternative effective self-stretching exercise.

Strength exercises: Strengthening muscles can reduce the likelihood of them developing trigger points in the future. Strengthening exercises includes high load, and low repetition of different groups of muscles.

Endurance exercise includes aerobic training such as running, swimming or biking, which strengthens both the cardiovascular system and multiple muscle groups. A regular exercise program minimizes the chance of reactivating trigger points.

Relaxation exercises such as contract-relax and yoga can help decrease mental stress and relax the body.

For best therapeutic results, exercise should be done under supervision of doctors and physical therapists. If done wrongly, exercise can be dangerous. For example, a rapid, forceful stretching motion could cause pain and muscle spasm; they tend to irritate muscle tissue and worsen trigger points, instead of releasing them.

>Back to contents

Where to treat myofascial pain syndrome? What are the options?

Best therapeutic results involve expertise of physical rehabilitation doctors, physical therapist and exercise trainers.

Physical rehabilitation will help patients analyze the root cause of their myofascial pain syndrome, and choose the most suitable modality of treatment. Sometimes, investigations such as MRI, X-ray, electromyography and nerve conduction study are needed.

Our Fix and Fit center has cutting edge technology for myofascial pain treatment, including electrotherapy, ultrasound diathermy therapy, laser therapy, shock wave therapy and peripheral magnetic stimulation.A

Peripheral magnetic stimulation (PMS) is a non-invasive method of delivering a rapidly pulsed, high-intensity magnetic field to the periphery. It is a novel and painless approach for musculoskeletal pain.

Shockwave therapy help in myofascial pain by alternating concentration of pain related substances, promoting angiogenesis and increasing perfusion at ischemic tissues. A shockwave is an acoustic wave which carries high energy to painful spots and myoskeletal tissues with subacute, subchronic and chronic conditions.

Spinal manipulation technology; our fix and fit center use state of the art traction table for the cervical and lumbar spine with three-dimensional correction arrangement to ensure best therapeutic achievement. This technique best suits patients with spinal scoliosis and chronic back pain.

Whole body cryotherapy or ice lab is the therapeutic application of extremely cold dry air, usually −110°C for 3 minutes. The ice lab can relive pain and inflammation in various musculoskeletal disorders. It is also popular amongst athletes as it can be used to promote recovery from sport injuries.

Moreover, we have multidisciplinary teams to help solve your pain problem. Our doctors include experts in rehabilitation, orthopedics, neurology, and psychiatry. Our physical therapists and gym trainers will also ceaselessly assist you to achieve your therapeutic goal.

You are all welcome to visit and have a consultation with our team at FIX&FIT Praram 9 hospital.

>Back to contents

Summary

Myofascial pain syndrome can affect your quality of life. However, you can prevent it by changing your lifestyle with these key factors – stretch and exercise regularly, adopt a proper ergonomic workstation, and maintain a proper posture.

However, if you already have myofascial pain syndrome, we recommend that you consult experts for treatment.

>Back to contents

Related Articles (10)

View All

Calcified Plaque in the Coronary Arteries: The Silent Killer!

Understanding the Causes of Blockage Many people believe that coronary artery disease develops only with age. However, coronary artery problems can begin much earlier in life. The risk starts in youth when fatty deposits (fatty streaks) begin to form in the coronary arteries. Over time, these deposits thicken, eventually leading to artery blockages. Dr. Anupong Parinayok, a cardiologist at Praram 9 Heart and Vascular Institute, explains that the problem begins when the inner lining of blood vessels becomes inflamed and dysfunctional, often due to chronic conditions such as diabetes, high blood pressure, and high cholesterol. Lifestyle factors, such as smoking, also play a significant role. These factors make the blood vessel walls more prone to inflammation, allowing oxidized LDL cholesterol to infiltrate and accumulate within them. Over time, this buildup forms plaques and calcium deposits in the coronary arteries. If these plaques rupture, they can trigger the formation of a blood clot, leading to an acute heart attack. At this stage, quick medical intervention is crucial to prevent life-threatening complications. Ideally, however, it is best to prevent reaching this stage.

Fear of the Sun? It Could Be Putting You at Risk for “Osteoporosis”

When people thinking of Thailand, many picture the sun, and just imaging it can make you want to grab an umbrella. But did you know that sunlight is more important to Thais than you might think? The gentle sunlight of the early morning and late afternoon not only warms the body but also helps produce vitamin D, which is crucial for strengthening bones, reducing the risk of osteoporosis. Many people view sunlight as harmful, causing skin damage, wrinkles, and hyperpigmentation, leading them to overlook its benefits. Studies show that sunlight is essential for preventing osteoporosis and vitamin D deficiency. Exercising under soft sunlight in the morning allows the body to absorb vitamin D, which strengthens bones and reduces the risk of osteoporosis. In Thailand, 2.5-3% of the population of all genders and ages suffer from osteoporosis. Dr. Peeraphong Sawatdipong, an orthopedic surgeon specializing in knee and hip replacements at Praram 9 Hospital, revealed that vitamin D deficiency is highly prevalent in Thailand, affecting 30-40% of patients. The primary cause is an excessive fear of sunlight, leading to fragile bones and a higher risk of fractures, particularly among the elderly and postmenopausal women. In reality, morning sunlight, when absorbed through the skin, significantly helps the body produce vitamin D, which strengthens bones and reduces the risk of osteoporosis later in life.

Why Are Young, Active People Still at Risk for Sudden Cardiac Arrest?

Recently, we’ve often heard of athletes—seemingly healthy and young—suddenly passing away, raising concerns about the true cause of sudden cardiac arrest (SCA) in athletes and young adults. Is there a connection with exercise? And how can we handle such situations to prevent unforeseen tragedies for ourselves and our loved ones? The Real Causes of Sudden Cardiac Arrest Dr. Phonpitchaya Boondee, a cardiologist at the Praram 9 Cardiovascular Institute, explains that the incidence of sudden cardiac arrest tends to increase with age. Among younger people, it occurs at a rate of 1:100,000, which rises to 50:100,000 in middle-aged adults and up to 200:100,000 in those over 80 years old. Additionally, men are more at risk of coronary artery disease than women. In young individuals with no underlying conditions, the primary cause of sudden cardiac arrest are usually electrical disturbances of the heart and hypertrophic cardiomyopathy. These are often genetic heart conditions that may present no prior symptoms, leaving individuals unaware they have heart disease.

Ovarian Cysts: A Hidden Threat Every Woman Should Know

These days, who would have thought that “ovarian cysts” would become a silent danger women need to be aware of? What’s even more concerning is that ovarian cysts often present no clear warning signs. Many women may be unaware that they have an ovarian cyst until they experience severe symptoms such as intense menstrual cramps, irregular periods, abdominal bloating, noticeable lumps in the pelvic area, or severe pain during intercourse. If left untreated, this condition can potentially be life-threatening. Unveiling the Secrets of Ovarian Cysts with a Specialist Professor Emeritus Dr. Sangchai Preutthipan, a specialist in reproductive medicine and laparoscopic surgery from Praram 9 Hospital, explains that the “ovaries” are small, thumb-sized organs responsible for producing eggs each month. With each ovulation, a fluid-filled sac forms around the egg. Sometimes, these sacs don’t dissolve as they should, leading to cyst formation. There are several types of ovarian cysts, including those caused by ovarian dysfunction, tumor-related cysts, endometriosis cysts (also known as chocolate cysts), cysts resembling other body tissues, and even cancerous cysts. Dr. Sangchai further notes that women of reproductive age up until menopause are at risk for ovarian cysts. Around 30-35% of women develop cysts due to ovarian dysfunction, while 20% develop tumor-related or chocolate cysts. Approximately 15% may have cysts that resemble other tissue types, and 1-5% are diagnosed with cancerous cysts. Each type of cyst carries different health risks.

Kidney Transplant Surgery Procedure, Recovery, and Complications to Monitor

Kidney transplantation is a surgical procedure that involves transplanting a kidney from a living donor or a donor who is brain-dead into a patient with chronic kidney failure, without removing the patient’s existing kidneys. The new kidney takes over the function of the damaged kidneys. The success rate of kidney transplantation is relatively high, and after the procedure, patients can experience a significant improvement in their quality of life. Therefore, kidney transplantation is considered the best treatment for chronic kidney failure. However, it is a major surgery with complex procedures. Before the operation, the donor kidney must be carefully matched to the recipient with chronic kidney failure, ensuring compatibility of blood and tissue between the donor and recipient to prevent rejection. Once a suitable kidney is found, the surgeon will perform the transplant on the patient. During and after the surgery, patients may face the risk of serious complications, so they must be closely monitored by a medical team. After the surgery, patients need to recover in the hospital to ensure that the new kidney is functioning properly and effectively.

Protect Yourself from Monkeypox: Know the Signs and Stay Safe

The World Health Organization (WHO) has declared a global health emergency due to a severe outbreak of monkeypox across Africa, where more than 450 deaths have been reported. Previously, in 2022, the WHO declared a public health emergency due to an outbreak of Clade 2, which is known for its milder symptoms. Although Clade 2 spread to over 100 countries, including Europe and Asia, it resulted in more than 87,000 cases and 140 deaths, with a mortality rate of 4%. The outbreak was primarily concentrated among the LGBTQ+ community, which allowed for targeted vaccination efforts to contain it effectively. This time, however, the outbreak involves Clade 1, which is much more severe, with a mortality rate of up to 10%. According to the Africa Centers for Disease Control and Prevention (Africa CDC), more than 14,500 monkeypox cases and over 450 deaths were reported between early 2024 and July, This represents a 160% increase in infections and a 19% increase in deaths compared to the same period in 2023.

How Long Can A Kidney Transplant Recipient Live After Surgery?

The kidneys are vital organs in the body, making kidney disease a significant issue that affects both the patient’s quality of life and the lives of those who care for them. Today, there has been an increase in kidney disease cases compared to the past, with a growing number of patients reaching end-stage chronic kidney failure and requiring urgent treatment. Kidney transplantation is considered the best treatment option for restoring the patient’s quality of life.

Thyroid Disease Symptoms! Which type of thyroid disease do these symptoms indicate?

The thyroid gland is a butterfly-shaped organ located at the front of the neck. Its main function is to produce thyroid hormones, which are crucial for the body’s metabolic system. These hormones also contribute to growth and regulate heart rate, body temperature, and other hormonal functions. When the thyroid gland malfunctions, it can affect the levels of thyroid hormones in the body, leading to conditions like hyperthyroidism (excess thyroid hormone), hypothyroidism (insufficient thyroid hormone), or other thyroid disorders. Patients with these conditions may exhibit different symptoms. This article will explain the symptoms of various types of thyroid diseases to help you recognize them early. If you suspect any issues, it’s important to consult a doctor for prompt diagnosis and treatment.

Cardiac Arrhythmia : A warning sign that may lead to heart failure

The heart is an essential organ that works tirelessly all the time. On average, the heart beats around 100,000 times a day. Nowadays, heart disease is becoming increasingly common and close to us. We often hear news of people we know, or those close to us, passing away due to heart disease, or instances of athletes collapsing during competitions caused by irregular heartbeats. Cardiac arrhythmia is considered a type of heart disease that is frequently mentioned today. An irregular heartbeat causes abnormal heart contractions. If severe and left untreated, it can lead to heart failure. Therefore, taking care of heart health is extremely important and should not be neglected.

Gynecologic Laparoscopic Surgery: A Great Option for Women

When it comes to women’s surgeries, besides the anxiety about the results, the pain from the surgery and the scars afterward are other significant concerns. Nowadays, medical advancements have provided women with treatment options that yield good results while leaving only small scars. The pain from the surgical wound is minimal, recovery is quick, and there are no severe complications. One such option is gynecologic laparoscopic surgery.

1270

About Us

Medical Center

Find a Doctor

Appointment

Health Articles

Hospital News & Events

Investor Relations

Sustainable Business Development

Join Us

Terms & Conditions

Myofascial pain syndrome (Office Syndrome)